Sexual practices and health care of women who have sex with women: 2013-2014. / Práticas sexuais e cuidados em saúde de mulheres que fazem sexo com mulheres: 2013-2014.

OBJECTIVE: to describe sexual practices and health care of women who have sex with women (WSW). METHODS: this was a cross-sectional study with data obtained by means of an electronic questionnaire answered by WSW from the five regions of the country (2013-2014). RESULTS: among 582 WSW, oral sex (95.2%) and digital penetration of the vagina (97.3%) were predominant, with rare use of barrier methods (6.7% and 5.8%, respectively); in the last five years, women who had sex exclusively with women, compared to those who had sex with women and men, were less likely to use barrier methods with women (28.3% versus 41.1%; p=0.041), less likely to have an annual check-up with a gynecologist (38.9% vs. 70.8%; p=0.033), less likely to receive guidance about sexually transmitted infections (STI) (44.0% vs. 59.1%; p=0.034) and about sexual doubts (50.0% vs. 63.0%; p=0.044). CONCLUSION: infrequent use of barrier methods may be a vulnerability factor for STI; it highlights the importance of guidelines for adequate health care for WSW.

Disclosure of Sexual Orientation Among Women Who Have Sex With Women During Gynecological Care: A Qualitative Study In Brazil.

BACKGROUND: Evidence shows that women who have sex with women (WSW) face disparities in access to health care when compared to heterosexual women in several countries. AIM: To investigate the experiences WSW have after disclosure of sexual orientation during gynecological care in Brazil. METHODS: We performed a qualitative study using content analysis. We recorded and transcribed interviews with 34 WSW from the 5 regions in Brazil. Data were analyzed using descriptive content analysis. OUTCOMES: The main categories of analysis were decision-making process to disclose and attitude of gynecologists after disclosure. RESULTS: WSW disclosed their sexual orientation in an un-favorable environment. Gynecologists rarely asked about patients' sexual orientation and used a script for hetero-normative anamnesis. The reactions of gynecologists were discriminatory, resulting in abbreviated consultations and un-comfortable gynecological exams. They missed a window of opportunity for prevention, diagnosis, and treatment of various diseases. The experiences Brazilian WSW had during gynecological care demonstrated the dominant hetero-normativity in the health care scenario. The attitudes of the gynecologists precarized the existence of WSW in health service. CLINICAL IMPLICATIONS: This study suggests that gynecologists missed an opportunity to use WSW's sexual orientation disclosure to offer specific care to them. STRENGTHS & LIMITATIONS: This is the first qualitative study about WSW's experiences during gynecological care in Brazil. Future studies should be developed from a wider sampling, especially among lower-class WSW. CONCLUSION: The results point out the need for a change in medical training and guidelines to assist WSW in the country. Rufino AC, Madeiro A, Trinidad AS, et al. Disclosure of Sexual Orientation Among Women Who Have Sex With Women During Gynecological Care: A Qualitative Study In Brazil. J Sex Med 2018;15:966-973.

Práticas sexuais e cuidados em saúde de mulheres que fazem sexo com mulheres: 2013-2014 / Prácticas sexuales y cuidados en salud de mujeres que tienen sexo con mujeres: 2013-2014 / Sexual practices and health care of women who have sex with women: 2013-2014

Objetivo: descrever práticas sexuais e cuidados em saúde de mulheres que fazem sexo com mulheres (MSM). Métodos: estudo transversal, com dados obtidos por questionário eletrônico, de MSM das cinco macrorregiões do país (2013-2014). Resultados: entre 582 MSM, predominaram o sexo oral (95,2%) e a penetração vaginal digital (97,3%), com raro uso de método de barreira (6,7% e 5,8%, respectivamente); nos últimos cinco anos, mulheres que fizeram sexo exclusivo com mulher, comparadas àquelas que fizeram sexo com mulher e homem, foram menos propensas a usar método de barreira na prática com mulher (28,3% versus 41,1%; p=0,041), realizar consulta anual com ginecologista (38,9% vs 70,8%; p=0,033) e receber orientações sobre infecções sexualmente transmissíveis (ISTs) (44,0% vs 59,1%; p=0,034) e sobre dúvidas sexuais (50,0% vs 63,0%; p=0,044). Conclusão: uso infrequente de métodos de barreira pode ser fator de vulnerabilidade para ISTs; destaca-se a importância da adoção de diretrizes para assistência adequada às MSM.

Objetivo: describir prácticas sexuales y cuidados en salud de mujeres que tienen sexo con mujeres (MSM). Métodos: estudio transversal con datos obtenidos por cuestionario electrónico, de MSM de las cinco grandes regiones del país (2013-2014). Resultados: entre 582 MSM, predominaron el sexo oral (95,2%) y la penetración vaginal digital (97,3%), con poco uso de método de barrera (6,7% y 5,8%, respectivamente); en los últimos cinco años, mujeres que tuvieron sexo exclusivo con mujer, comparadas a las que tuvieron sexo con mujer y hombre, fueron menos propensas a usar método de barrera con mujer (28,3% versus 41,1%; p=0,041), a realizar consulta anual con ginecólogo (38,9% vs 70,8%; p=0,033) y a recibir orientaciones sobre infecciones de transmisión sexual (ITS) (44,0% vs 59,1%; p=0,034) y sobre dudas sexuales (50,0% vs 63,0%; p=0,044). Conclusión: el uso infrecuente de métodos de barrera puede ser factor de vulnerabilidad para ITS; se destaca la importancia de la adopción de directrices para asistencia adecuada de MSM.

Objective: to describe sexual practices and health care of women who have sex with women (WSW). Methods: this was a cross-sectional study with data obtained by means of an electronic questionnaire answered by WSW from the five regions of the country (2013-2014). Results: among 582 WSW, oral sex (95.2%) and digital penetration of the vagina (97.3%) were predominant, with rare use of barrier methods (6.7% and 5.8%, respectively); in the last five years, women who had sex exclusively with women, compared to those who had sex with women and men, were less likely to use barrier methods with women (28.3% versus 41.1%; p=0.041), less likely to have an annual check-up with a gynecologist (38.9% vs. 70.8%; p=0.033), less likely to receive guidance about sexually transmitted infections (STI) (44.0% vs. 59.1%; p=0.034) and about sexual doubts (50.0% vs. 63.0%; p=0.044). Conclusion: infrequent use of barrier methods may be a vulnerability factor for STI; it highlights the importance of guidelines for adequate health care for WSW.